Electrical activity of the heart Flashcards

1
Q

What is the combination of electrical and physical connections in cardiac muscle called?

A

Functional syncytium

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2
Q

What is cardiac muscle electrically connected by?

A

Gap junctions which are protein channels

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3
Q

What physically connects cardiac muscle?

A

Desmosomes

These form intercalated discs

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4
Q

What are T-tubules?

A

Deep invaginations of sarcolemma

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5
Q

What is the sarcoplasmic reticulum?

A

Essentially the calcium store

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6
Q

What do the intercalated discs do?

A

Allow the cardiac muscles to act like one cell even though each cell has its own nucleus

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7
Q

What is the sequence of events for contraction?

A
  • Action potential enters via contractile cell and moves across sarcolemma and into t-tubules
  • Calcium flows out of SR and into cytosol
  • Diffuses across cytosol to the contractile elements
  • Binds to troponin and initiates cross-bridge formation and sliding filament movement
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8
Q

What happens in relaxation?

A
  • When cytoplasmic calcium concentrations decrease, calcium unbinds from troponin
  • Myosin releases actin
  • Contractile filaments slide back to their relaxed position
  • Calcium is transported back to ST via Ca2+-ATPase
  • Calcium is removed from the cell in exchange for Na+
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9
Q

How does the cardiac cell have a graded contraction?

A
  • Force generated is proportional to number of active cross-bridges
  • Number of cross-bridges active is determined by how much Ca2+ is bound to troponin
  • If more calcium enters from the extracellular fluid, more Ca2+ is released from SR
  • Myosin forms more cross-bridges with actin
  • Additional contractile force
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10
Q

What is the resting membrane potential of a non-pacemaker cell? Why?

A
  • 80mV

Due to high resting P_K+

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11
Q

Why does the initial depolarisation in a non-pacemaker cell occur?

A

Increase in P_Na+

Cardiac cells have high voltage gated sodium channels and open when there’s a huge depolarisation

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12
Q

Why does the action potential plateau in a non-pacemaker cell?

A

Increase in P_Ca2+ and increase in P_K+
The slower voltage gated calcium channels open
Potassium permeability also drops to allow for further depolarisation

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13
Q

What causes repolarisation in non-pacemaker cells?

A

Calcium channels shut and permeability increase for K+

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14
Q

Why is there a long refractory period in non-pacemaker cells?

A

Slower voltage gated sodium channels opening
Last for as long as muscle twich
Prevents tetanus as there’s no summation

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15
Q

What is initial membrane potential of a pacemaker cell?

A

It is -60 mV and gradually rises to a threshold of -40 mV

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16
Q

Why is the pacemaker potential so complex?

A

Gradual decrease in Pk+, leakiness decreases
Early increase in PNa+, increase in permeability opened by repolarisation from previous action potential
Late increase in PCa2+, tiny calcium channels that let calcium in

17
Q

What are some examples of modulators of electrical activity?

A
  • Sympathetic and parasympathetic systems
  • Drugs
  • Temperature
  • Hyper/hypokalaemia
  • Hyper/hypocalcemia
18
Q

Specifically which drugs modulate electrical activity? What do they do?

A

Ca2+-channel blockers: decrease force of contraction

Cardiac glycosides: increase force of contraction, calcium

19
Q

How does temperature alter electrical activity?

A

Increases by ~10 beats/min/°C
Ions pass through channels quicker
This is why there’s tachycardia in fever

20
Q

How does hyperkalaemia modulate electrical activity?

A

High plasma K+

Fibrillation & heart block

21
Q

What is fibrillation?

A

Depolarises cells
Action potentials fire spontaneously
Leads to uncoordinated firing

22
Q

What is heart block?

A

Depolarised speed of propagation slows down

Can slow down so much that it stops

23
Q

How does hypokalaemia modulate electrical activity?

A

Fibrillation and heart block
Starts to polarise and then depolarise
Same net effect as hyperkalaemia

24
Q

How does hypercalcemia modulate electrical activity?

A

High plasma Ca2+

Increased HR and force of contraction

25
Q

How does hypocalcemia modulate electrical activity?

A

Decreased HR and force of contraction

26
Q

What is the order of the spread of electrical activity?

A

SAN -> annulus fibrosus -> atrioventricular node -> bundle of His -> Purkinje fibres

27
Q

What is the sinoatrial node?

A

Pacemaker
Gives off a slow moving wave of depolarisation
Heart will beat to the fastest pacemaker which is the SAN
0.5 m/s

28
Q

What is the annulus fibrosus?

A

Non-conducting, no signal

Junction between the atria and ventricles

29
Q

What is the atrioventricular node?

A

Delay boxy
Signal canot go through annulus fibrosus so it has to go through the AVN
Slows down AP to allow blood out
0.05m/s

30
Q

What is the bundle of His?

A

Spilts into the left and right bundle branch

31
Q

What are the Purkinje fibres?

A

Come from bundle branches
Rapid conduction system
5m/s

32
Q

What does the P wave correspond to?

A

Atrial depolarisation

33
Q

What does the QRS complex correspond to?

A

Ventricular depolarisation

34
Q

What does the T wave correspond to?

A

Ventricular repolarisation